Mt. Tabor Family Medical Group, P.c.
NPI #1548416944 in Portland, Oregon
Provider Information
- NPI Number
- 1548416944
- Entity Type
- Organization
- Organization Name
- Mt. Tabor Family Medical Group, P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Aug 18, 2008
- Last Updated
- Jul 2, 2010
Practice Location
Authorized Official
- Name
- KENNY HEINE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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